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C,"`°t°°f` - Application for a Permit to Build No. 2/7/
UPON FINAL APPROVAL e..t. a MAP LOT
FEE MUST ACCOMPANY THIS APPLICATION. DATE 19, O
The undersigned hereby applies for a permit to build moi/
according to the following specifications er/'/9d
1. Name of property owner I,E&Rfnt A.14 W a Ns41.b n Tel.PS---3-‘4 V> •
Address JRb A kit uW / G Q-1) W yi9P01O11771
2.Name of Architect(if any) Tel:
3. Name of builder L F Address
4. License No. Tel.
5. Name of Mason Address
6. License No: Tel.
7. Construction address /2 6 h (Cuff s R b'
Flood District
8. Date of subdivision Approval plain zone Zone
9. Private dwelling4a Estimated Cost DO NOT WRITE IN THIS SPACE
Type of room No.
10. Multi family 0 ":3–‘,00 -12,1;7/1i.gNNDsyIz i
11.Commercial 0 jltc's._V kr/Kitchen
12. Other I 71)1/// Dining Rm.
13. No. of stories Living Rm.
oP 00 Bed Rm.
14. Foundation — Full 0 Half 0 Crawly( Slab 0 Bath
15. Materials Wood g. Cement 0 Other 0 Deck
16.Type of heat — Oil 0 Gas A Electric 0 Other 0 Closed porch
17. Garage — 1 ❑ 2 ❑ Family Rm.
Sun room
18.Swimming pool - Size Garage
19. Storage shed — Size , Shed
20. Stove - Wood ❑ Coal 0 Alterations
21. Size of lot: No. of feet front No. of feet rear No. of feet deep
22. Size of building: No. of feet front No.of feet side No. of feet rear -
23. Distance from nearest building: Front Ft. side Ft. side Rear
24. Distance back from line or street From rear lot line Side line
41
LOT RELEASED BY Signature X411 . � I
PLANNING BOARD Address! /d& pzi.%_cwo
Date l� j4 g,s
t /
BUILDING PERMIT APPLICATION SIGN OFF
APPLICANT: /070(nn!F t /60,4-1..hp BUILDING PERMIT ll:
ADDRESS: )meq/, xrwtS !f?) TELE. NO. : )),1--,S-.24,(> DATE FILED: 7/00
BLDG. SITE LOCATION: /at z° ,fie{ uJ }til vet/MAPOC: LOU:
THE FOLLOWING INFORMATION OUTLINES THE PROCEDURAL STEPS REQUIRED TO OBTAIN A PERMIT TO BUILD,
ALTER, OR ADD TO A STRUCTURE WITHIN THE TOWN OF YARMOUTH. THE BUILDING DEPARTMENT WILL DETER-
MINE COMPLIANCE TO THE FOLLOWING (A) ZONING REQUIREMENTS (B) HISTORICAL DISTRICTS (C) FLOOD
PLAINS ZONING. THE BUILDING DEPARTMENT WILL BE RESPONSIBLE FOR ASSISTING THE APPLICANT THOUGH
THE FOLLOWING DEPARTMENTS:
RESIDENTIAL AND/OR COMMERCIAL BUILDING
WATER DEPARTMENT: DETERMINES COMPLIANCE OF WATER AVAILABILITY.
ENGINEERING DEPARTMENT: DETERMINES COMPLIANCE FOR PARKING AND DRAINAGE.
CONSERVATION COMMISSION: DETERMINES COMPLIANCE TO WETLANDS ACTS, I.E.: IF LOT(S) BORDER ANY
TYPE OF WETLANDS, STREAMS, PONDS, RIVERS, OCEANS, BOGS, BAYS, MARSH
LAND, ETC.
HEALTH DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REGULATIONS, I.E.: REQUIRE-
MENTS FOR SEPTAGE DISPOSAL AND OTHER PUBLIC HEALTH ACTIVITIES.
FIRE DEPARTMENT: DETERMINES COMPLIANCE TO STATE AND TOWN REQUIREMENTS FOR PERSONAL
SAFETY, PROPERTY PROTECTION, I.E., SMOKE DETECTORS, SPRINKLER SYSTEMS,
ETC.
THE FOLLOWING DEPARTMENTS MUST SIGN OFF, IN THE RESPECTIVE ORDER, PRIOR TO BUILDING INSPECTOR
ISSUING THE REQUIRED BUILDING PERMIT:
REVIEWED BY:
1. WATER DEPARTMENT DATE: N/A:
2. ENGINEERING DEPARTMENT: DATE: N/A:
3. CONSERVATION: DATE: N/A:
�`J
4. HEALTH DEPARTMENT �F f�Z DATE: 14(/)Q N/A:
INDUSTR li /OR COMMERCIAL PERMITS
5. WIRING INSPECTOR: DATE: N/A:
6. PLUMBING INSPECTOR: DATE: N/A:
7. FIRE DEPARTMENT: DATE: N/A:
•
PLEASE NOTE
ALL STUMPS AND/OR BRUSH MUST BE DISPOSED OF AT AN APPROVED SITE. A SIGNED RECEIPT FROM THE
DISPOSAL SITE MUST BE SUBMITTED TO THE BUILDING DEPARTMENT PRIOR TO ISSUANCE OF THE BUILDING
PERMIT.
COMMENTS:
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BLM/89
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TOWN OF YAMOUTH
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
PLEASE PRINT:
DATE 71/3//4
0
JOB LOCATION /�/, rlt)I $ 2 7) l)r-5r //7RYKOtnt/
NUMBER STREET ADDRESS SECTION OF TOWN
"HOMEOWNER" Z u)Rtripk,filQ#Al f) L )O 77: SJa y7
NAME HOME PHONE WORK PHONE
PRESENT MAILING ADRESS /a6 &r- Lv I s RD
kYa-o wo Jiff itwpgs va 6
C OR TOWN STAT ZIP CODE
THE CURRENT EXEMPTION FOR "HOMEOWNER" WAS EXTENDED TO INCLUDE OWNER-OCCUPIED
DWELLINGS OF SIX UNITS OR LESS AND TO ALLOW SUCH HOMEOWNERS TO ENGAGE AN IN-
DIVIDUAL FOR HIRE WHO DOES NOT POSSESS A LICENSE, PROVIDED THAT THE OWNER
ACTS AS SUPERVISOR. (STATE BUILDING CODE SECTION 109.1.1)
DEFINITION OF HOMEOWNER:
PERSON(S) WHO OWNS A PARCEL OF LAND ON WHICH HE/SHE RESIDES OR INTENDS TO RE-
SIDE, ON WHICH THERE IS, OR IS INTENDED TO BE A ONE TO SIX FAMILY DWELLING,
ATTACHED OR DETACHED STRUCTURES ACCESSORY TO SUCH USE AND/OR FARM STRUCTURES.
A PERSON WHO CONSTRUCTS MORE THAN ONE HOME IN A TWO-YEAR PERIOD SHALL NOT BE
CONSIDERED A HOMEOWNER. SUCH "HOMEOWNER" SHALL SUBMIT TO THE BUILDING OFFICIAL,
ON A FORM ACCEPTABLE TO THE BUILDING OFFICIAL, THAT HE/SHE SHALL BE RESPONSIBLE •
FOR ALL SUCH WORK PERFORMED UNDER THE BUILDING PERMIT. (SECTION 109.1.1)
THE UNDERSIGNED "HOMEOWNER" ASSUMES RESPONSIBILITY FOR COMPLIANCE WITH THE STATE
BUILDING CODE AND OTHER APPLICABLE CODES, BY-LAWS, RULES AND REGULATIONS.
THE UNDERSIGNED "HOMEOWNER" CERTIFIES THAT HE/SHE UNDERSTANDS THE TOWN OF YARMOUTH
BUILDING DEPARTMENT MINIMUM INSPECTION PROCEDURES AND REQUIREMENTS AND THAT HE/SHE
WILL COMPLY WITH SAID PRO I ' I ' . AND ' QUIREMENTS.
INzHOMEOWNER'S SIGNATURE lit # I l .1
APPROVAL OF BUILDING OFF IAL ,./�1,0 f,
NOTE: THREE FAMILY DWELLINGS 35,000 CUBIC FEET, OR LARGER, WILL BE REQUIRED
TO COMPLY WITH STATE BUILDING CODE SECTION 127.0, CONSTRUCTION CONTROL.
r
• \' PLOT PLAN
FOR LOT #.
Indicate location of garage or accessory building
Additions with dashed lines
Sewerage disposal (cesspool) E
Well 0
I
(lot f ft. rear) I
Abuttor's I Abuttor's
Name I Name
Lot # W I Lot #
REAR YARD
If this is a CY If this is
corner lot, CXIS;# . . . . . ...ft. corner to
write in name kN write in
•
of street. (,• I name of
.I.. . /SW 1 Ia, other
- �• 8 street. .
fcsFt,
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SIDE YARD SIDE YARD
HOUSE '
0 1 FT. I) 0_ 2 c
� FT0' .
•
•
SET BACK
•
ft.30
(lot 1 v° ft. frontage)
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\ / (NAME OF STREET)
Information 0
/ \ \ Supplied by fai.guiL
MARK NORTH POINT